彩色多普勒与CTA在颈动脉血管支架置入术中的对比研究

Comparative study of the value of color Doppler ultrasonography and multi-slice CT angiography in the stent-assisted angioplasty of carotid artery stenosis

目的:探讨双功能彩色多普勒(CDFI)和多层螺旋CT血管成像(MSCTA)在颈动脉狭窄血管内支架置入术中的应用价值。方法:回顾性分析行颈动脉支架置入的36例患者治疗前后的CDFI及MSCTA的影像资料,以DSA为标准,比较CDFI和MSCTA两种方法对颈部血管狭窄程度判断及粥样硬化斑块密度分析的符合率;比较这两种方法在颈动脉狭窄血管内支架置入术中的应用价值。结果:CDFI及MSCTA诊断颈动脉狭窄的敏感度分别为90.9%和92.8%,特异度分别为95.6%和95.7%,诊断符合率分别为92.4%和93.8%,阴性预测值分别为82.7%和86.5%,阳性预测值分别为97.8%和97.8%。MSCTA检出粥样动脉硬化斑块分型与CDFI的符合率为86.9%。结论:在颈动脉狭窄血管内支架置入术影像学检查中,CDFI可作为颈动脉病变筛查、术后疗效评价及随访的首选检查方法,MSCTA显示高位分叉的颈内动脉、颈内动脉入颅段及血管走向变异更有优势,两者结合可提高诊断符合率。

Objective：To evaluate the value of multi-slice CT angiography（MSCTA） and ultrasonography color Doppler flow imaging（CDFI） in the stent-assisted angioplasty of carotid artery stenosis（CAS）.Methods：The imaging data of MSCTA and CDFI before and after stent-assisted angioplasty of CAS in 36 patients were analyzed retrospectively.Digital subtracted angiography（DSA） was used as the golden standard.The accuracy of evaluating the degree of CAS and the density of arterio-sclerotic plaque by CDFI and MSCTA as well as the value of these two techniques in stent-assisted angioplasty of CAS were compared.Results：The sensitivity of CDFI and MSCTA in the diagnosis of CAS was 90.9% and 92.8% respectively,the specificity was 95.6% and 95.7% respectively,the accuracy was 92.4% and 93.8% respectively,negative predictive value was 82.7% and 86.5% respectively,positive predictive value was 97.8% and 97.8% respectively.The coincidence rate of analyzing carotid atherosclerosis plaque by CDFI and MSCTA was 86.9%.Conclusion：For the stent-assisted angioplasty of CAS,CDFI could be used for screening of carotid artery lesion,evaluation of treatment effect and follow up.MSCTA is superior in displaying high position bifurcation,intra-cranial segment of internal carotid artery and the variation of carotid artery pathway.The accuracy of diagnosis could be improved with CDFI in combination with MSCTA.